Calling NICU nurses!!

Hi!

Yes, sometimes the babies cry nonstop, some are sedated, the families can be challenging, and we do titrate drips. Spending a day shadowing a NICU nurse will provide invaluable insight into the daily workflow. Try to spend some time with the very sick infants and the ones on the launchpad (going home), so to speak. And remember, neonates are not just tiny adults. :)

I was an experienced adult ICU nurse before coming to a level III NICU. Being used to a critical care environment was helpful in making my transition, as was having my head around time management and prioritization. However, nearly EVERYthing is different with these little ones. Vent settings, hemodynamics, acceptable lab values, nutrition, med doses (and at times even mechanism of action)... It's a whole new ballgame. Even the way you manage your time will be different. We also have a lot less autonomy, which I am personally fine with. At times I miss running 15 pumps at once and titrating a bunch of pressors, but I enjoy being in a more tightly run environment.

As for your questions... No, we don't titrate gtts independently in my unit, but we of course know when things are outside parameters and anticipate what needs to be done. Some babies are sedated but a lot of them do just fine on a vent without sedation; we only use it when needed, usually on the bigger babes. Some babies cry a lot, particularly those going through drug withdrawal and those "chronics" that have been on the unit for a long time, but most can be easily soothed (cuddle time!). Parents run the spectrum and some can be very difficult. Having a NICU baby is not something that anyone plans for, and their reactions are varied. Parent teaching starts from day one. Always remember, it's their baby -- they need to be the experts! Sure it's satisfying to see a baby make progress and be ready to go home, but it's incredibly rewarding to have a family go from sobbing in the corner to being completely independent in caring for their infant.

I did a residency with some new grads, and for the most part my transition was easier than theirs. I moved on to working with the very critical babies more quickly than they did. But expect to struggle some. It's not as challenging as it was being brand new in the adult ICU, but I was (and still am) very far outside of my comfort zone. I wouldn't change it for the world, though! It's an amazing environment and I can't see myself doing anything else. Ever. Good luck to you!

Thank you so much for your responses! Going into ICU as a new grad was difficult, and I'm realizing Id almost be starting from scratch in the NICU. thanks all!